A method for automatically monitoring the penetration behavior of a trocar held by a robotic arm and monitoring system is provided.
Medical technology endoscopic robotic systems with robotic arms may be used to assist the physician or surgeon during a surgical procedure. The robotic system may serve as a guide, carrier, and instrument holder. The motorized drives of the robotic system allow movements and positionings with a high repetitive accuracy while significantly relieving the burden on the surgeon. Robotic systems with robotic arms that may be moved by an operator's touch are also known; accordingly, interactive operation without conventional operating elements and control sticks is possible.
However, in general, robotic systems have previously only been used successfully where all parameters of the surroundings are fixed, predictable, or may be measured using the senses. Flexible parameters, such as the surface of the body of a patient during a laparoscopic operation, e.g. due to the abdominal area filled with gas such as CO2, may not be calculated by way of parameters. Knowledge of the position of the abdominal wall is very important since the pivot point for an inserted instrument results therefrom. An optimally positioned pivot point is important so as few translatory forces as possible act on the abdominal wall of the patient during rotational movements of the robotically held and moved instrument.
The entry into a body cavity, such as e.g. the abdominal area, of a patient may be enabled by what is known as a trocar. The trocar is thrust through an incision in the skin and, even during removal of the instruments, dispatches the gas that has filled the abdominal area. The trocar has flexible penetration depth and, depending on the situation, is forced through to different depths, e.g. into the abdominal area filled with gas. During a manually conducted procedure with an instrument, a surgeon constantly observes the deformation of the abdominal area in order to compensate gas that potentially needs to escape or released gas during the surgeon's movements. An incorrect application of force, and therewith possible complications, may be avoided by way of the perceived force application. Without knowledge of the pivot point, the surgeon manually moves or controls the instrument himself completely in all degrees of freedom. The surgeon constantly visually monitors the pressure in the abdominal area or responds to insufflator alarms. Alternatively, manual compensation by the surgeon is absent if the instrument is held or guided by suitable robotic systems.